Heat-Related Mortality in Japan after the 2011 Fukushima Disaster: An Analysis of Potential Influence of Reduced Electricity Consumption

Background: In March 2011, the Great East Japan Earthquake devastated several power stations and caused severe electricity shortages. This accident was followed by the implementation of policies to reduce summer electricity consumption in the affected areas, for example, by limiting air-conditioning (AC) use. This provided a natural experimental scenario to investigate if these policies were associated with an increase in heat-related mortality. Objectives: We examined whether the reduced electricity consumption in warm season modified heat-related mortality from 2008 to 2012. Methods: We conducted prefecture-specific interrupted time-series (ITS) analyses to compare temperature?mortality associations before and after the earthquake, and used meta-analysis to generate combined effect estimates for the most affected and less affected areas (prefectures with >10% or ?10% reductions in electricity consumption, respectively). We then examined whether the temperature?mortality association in Tokyo, one of the most affected areas, was modified by the percent reduction in electricity consumption relative to expected consumption for comparable days before the earthquake. Results: Contrary to expectations, we estimated a 5?9% reduction in all-cause heat-related mortality after the earthquake in the 15 prefectures with the greatest reduction in electricity consumption, and little change in the other prefectures. However, the percent reduction in observed vs. expected daily electricity consumption after the earthquake did not significantly modify daily heat-related mortality in Tokyo. Conclusions: In the prefectures with the greatest reductions in electricity consumption, heat-related mortality decreased rather than increased following the Great East Japan Earthquake. Additional research is needed to determine whether this finding holds for other populations and regions, and to clarify its implications for policies to reduce the consequences of climate change on health